Healthcare Provider Details

I. General information

NPI: 1629369079
Provider Name (Legal Business Name): ERIKA COLLINS CRAVANAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ROGERS RD STE 210
WAKE FOREST NC
27587-5745
US

IV. Provider business mailing address

3000 ROGERS RD
WAKE FOREST NC
27587-5743
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-2120
  • Fax: 919-385-2144
Mailing address:
  • Phone: 919-385-2120
  • Fax: 919-385-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2020-02286
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: